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3.7 CHANGES OF INTRINSIC STIFFNESS OF THE CAROTID ARTERIAL WALL DURING THE CARDIAC CYCLE MEASURED BY SHEAR WAVE ELASTOGRAPHY IN HYPERTENSIVES COMPARED TO NORMOTENSIVES
oleh: Louise Marais, Mathieu Pernot, Hakim Khettab, Michael Tanter, Emmanuel Messas, Mustapha Zidi, Stéphane Laurent, Pierre Boutouyrie
Format: | Article |
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Diterbitkan: | BMC 2017-12-01 |
Deskripsi
Objective: Because measurement of arterial stiffness is highly dependent on blood pressure (BP), methods independent of BP are required. Shear wave elastography (SWE, Supersonic Imagine, Aix-en-Provence, France) enables to assess local tissue stiffness by tracking the propagation of shear waves generated into the tissue using ultrafast imaging. This method has never been tested against classical Echotracking (Artlab, Esaote, Maastricht, NL) and carotid to femoral pulse wave velocity (cf-PWV, Sphygmocor, AtCor, Sydney, Australia). Methods: We included 25 subjects, 14 normotensives (NT) and 11 essential hypertensives (HT), matched for age and sex. We optimized SWE algorithms for carotid wall tracking and shear wave group velocity calculation for the anterior (a-SWV) and posterior wall (p-SWV). 8 ultrasonic pushes were triggered at intervals of 200 ms to study the variations of stiffness during the cardiac cycle. Results: p-SWV showed no association with carotid PWV, cf-PWV nor BP. Mean a-SWV over the cardiac cycle was strongly associated with carotid PWV measured by Echotracking (r = 0.56, p = 0.003) and cf·PWV (r = 0.66, p < 0.001). a-SWV strongly increased with BP level during the cardiac cycle (p < 10−6). Similar associations between a-SWV and BP were found in NT and HT although HT had higher values of a-SWV throughout all BP levels. However, when a common BP value (100 mmHg) was considered, no significant difference was found between NT and HT. Conclusion: We have demonstrated with a method independent of BP that the increased arterial stiffness in HT is entirely due to the BP increase. SWE seams a promising technique for assessing arterial stiffness.